Tag: Physician Practice Management

I recently read news that really brought home the real-life impact on patient care —really, on patient’s lives—of an effective prior authorization (PA) process. In February 2019, long-time disability rights activist and attorney Carrie Ann Lucas died prematurely at age 47 from a plethora of health problems, exacerbated by her disabilities.

However, according to a post following her passing on her Facebook page, her friends and family identify the root cause as the denial by her insurance carrier of “the one specific inhaled antibiotic that she really needed. She had to take a less effective drug and had a bad reaction to that drug. Read the full article.

Pharma brands invest heavily in sales and marketing tactics aimed at convincing physicians to prescribe their product. Even when successful, these efforts represent only a first step in realizing more prescriptions that actually get dispensed. Particularly when a prescription requires prior authorization (PA), retail pharmacy data shows that the originally prescribed product ends up being dispensed less than thirty percent of the time. In two-thirds of cases, the medication is either switched to another product or abandoned altogether, leaving both patients and physicians frustrated. PA requirements are being implemented by payers for more brands across most therapeutic categories, so the negative impact on pharma continues to deepen. Read the full article

For many pharmaceutical brands, managed care restrictions put tremendous pressure on the ability for patients to access prescribed medications, even when their physicians deem a particular medication to be best suited to treat their condition. To combat this challenge, many brands have engaged third parties to implement programs designed to assist physician practices with managing the cumbersome prior authorization (PA) process. While these programs may help generate higher PA approval rates, this metric alone is insufficient in evaluating whether the program is truly beneficial to patients and impactful for the sponsoring brand. Read the full article

Now on our podcast page – the second installment of the “Meeting the Prior Authorization Challenge” podcast series! The newest episodes of this free resource cover maximizing optimal staff productivity in the face of a changing prior authorization landscape. PARx Director of Operations and Training Rabia Kabeer is joined by a Nurse Practitioner and a Practice Manager to deliver valuable insights into how PA’s have evolved, the pain points associated with them and how to give your staff the tools to make the most of their already busy schedules.

Topics addressed in this podcast series are:

Episode Four: How is the prior authorization landscape changing?
PARx’s own Director of Operations and Training Rabia Kabeer kicks off the staff productivity discussion by explaining how prior authorizations have changed over the last decade. She also provides an overview of our recent innovation, GUEST PASS, which allows any provider to submit a prior authorization using the PARx Prior Authorization Support System (‘PASS’), without going through the registration process.

PARx’s own Director of Operations and Training Rabia Kabeer kicks off the staff productivity discussion by explaining how prior authorizations have changed over the last decade.

Kabeer also provides an overview of our recent innovation, GUEST PASS, which allows any provider to submit a prior authorization using the PARx Prior Authorization Support System (‘PASS’), without going through the registration process.